Wolters Kluwer Health may email you for journal alerts and information, but is committed
to maintaining your privacy and will not share your personal information without
your express consent. For more information, please refer to our Privacy Policy.

Read Dr. Christine Butts’ article, “Ultrasound Critical in Saving Patient with Aortic Dissection,” in the May 2015 issue, and then watch this video that shows a transverse image of the aorta, seen just superficial to the vertebral body on the patient's left. An intimal flap can be seen as a hyperechoic lucency within the lumen of the aorta.

Read Dr. Christine Butts’ article, “Ultrasound Critical in Saving Patient with Aortic Dissection,” in the May 2015 issue, and then watch this video that shows an intimal flap vacillating with each heartbeat within the lumen of the aorta.

Read Dr. Christine Butts’ article, “RADiUS to the Rescue for Patients with SOB,” in the July issue, and then watch this video that shows that the patient has normal lung sliding bilaterally, ruling out a pneumothorax.

Read Dr. Christine Butts’ article, “RADiUS to the Rescue for Patients with SOB,” in the July issue, and then watch this video that shows that the patient’s IVC is enlarged, changing little with respiration. These findings correlate with an elevated central venous pressure.

Read Dr. Christine Butts’ article, “RADiUS to the Rescue for Patients with SOB,” in the July issue, and then watch this video that shows that the patient’s overall left ventricular function is severely decreased.

Read Dr. Butts’ article, “Comet Tails and Lung Sliding: Evaluating for Pneumothorax,” in the December 2013 issue, and then view this video that demonstrates lack of lung sliding associated with a pneumothorax. A rib is seen to the right of the image as the structure casting a large shadow. Just beneath the rib, the pleura is seen as a hyperechoic horizontal line. Careful observation reveals that the pleura is not sliding nor are comet tails visible.

Read Dr. Butts’ article, “Comet Tails and Lung Sliding: Evaluating for Pneumothorax,” in the December 2013 issue, and then view this video that demonstrates a normal “sliding” motion of the pleura back and forth. Comet tail artifacts are also seen to appear and disappear, emanating from the pleural border. The combination of the presence of sliding and comet tail artifacts virtually excludes a pneumothorax.

An indirect method for assessing proper placement of the ET tube is to watch the pleura for the presence of the slide sign. The pleura are easily identified from the anterior chest wall utilizing the high-frequency transducer. The transducer should be placed just inferior to the clavicle in the mid-clavicular line. Pointing the indicator toward the patient’s head will produce an image that is easy to interpret. Once the skin, soft tissue, and ribs have been identified, the pleura will be seen as a hyperechoic (white) line running just deep to the rib. In real time, the pleura slide back and forth with respiration.

Read Dr. Butts’ article, “The RADiUS Focused Cardiac Exam,” in the Breaking News blog, and then view this video that shows the subxiphoid view of a pericardial effusion demonstrating mass effect on the right ventricle (RV).

Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows the technique to assess the venous anatomy of the neck and to identify the subclavian vein (SCV). The high-frequency transducer should be placed in the transverse orientation just lateral to the trachea. Once the internal jugular (IJ) is identified, it can be followed inferiorly until it is seen to join the SCV. Angling the transducer anteriorly will help to visualize this junction.

Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows assessment of the venous anatomy as seen under ultrasound. The internal jugular (IJ) vein is seen as the triangular vessel that appears to fluctuate slightly with respiration. As the view progresses inferiorly, the IJ can be seen to join the SCV, which appears tubular in this orientation.

Read Dr. Butts’ article, “Think SUPRAclavicular for Subclavian Lines,” in the July 2013 issue, and then view this video that shows an “in-plane” approach to a vessel (using a simulator). As the needle is inserted from the end of the transducer, rather than at its mid-point, it traverses the path of the transducer. This enables the entire needle, including the tip, to be visible throughout the procedure, minimizing complications such as arterial puncture or pneumothorax.